Hundreds of doctors from government hospitals and dispensaries across Haryana launched a two-day strike beginning December 8, disrupting health services. The Haryana Civil Medical Services (HCMS) Association has warned that it may extend the strike indefinitely if grievances remain unresolved. The Indian Express outlines the reasons behind the agitation, the doctors’ key demands and their likely course of action.Medical officers in Haryana have been frustrated over limited promotional avenues after joining the state health department. According to HCMS Association general secretary Dr Anil Yadav, more than 95% of medical officers receive only one promotion in their entire career — from Medical Officer to Senior Medical Officer (SMO).The association identifies direct recruitment as the main hurdle. Under current policy, 75% of SMO posts are filled through promotions, while 25% are reserved for direct recruitment. Doctors argue that directly recruited SMOs progress far ahead in their career, often reaching the post of Director General, while in-service doctors stagnate.This issue has sparked unrest earlier as well. “In July 2024, the Association staged a two-day strike, which was withdrawn after government assurances that no further direct recruitment for SMOs would be done and service rules would be amended to ensure promotions,” says an association member. Those assurances remain unfulfilled, say members.What do the authorities say?Haryana’s Director General of Health Services Dr. Manish Bansal said that the department, in 2024, proposed filling SMO posts entirely through promotions as a one-time measure, but the government rejected this. Another senior officer noted that several departments follow a mixed system of promotions and direct recruitment, and some within the health department support continuing direct recruitment.Owing to opposition from the HCMS Association, however, no direct recruitment has taken place since 2012. The association argues that past recruitments were interview-based, leaving room for favoritism, and says most states do not recruit SMOs directly.Also Read | Goa nightclub blaze: Why most deaths in a fire are because of suffocation, not burnsThis standoff has created a deadlock: Neither direct recruitment nor promotions are happening. As a result, 210 SMO posts remain vacant out of 644 sanctioned positions, with 50 meant for promotion and the rest reserved for direct recruitment. The shortage has affected health services and administration at the local level.Story continues below this adWhat has the government done so far?To break the deadlock, Haryana Chief Secretary Anurag Rastogi invited the HCMS Association for dialogue on Friday, but no solution emerged. A meeting with the Chief Principal Secretary to the Chief Minister Rajesh Khullar also took place.Association sources indicate the government responded positively to banning direct recruitment, but refused to implement the Assured Career Progression (ACP) programme despite Chief Minister Nayab Singh Saini’s approval in July 2024.ACP is a structured promotion scheme that ensures timely career growth and financial security for medical officers, even if regular promotions are delayed. In Haryana, the scheme provides financial upgradation after five, 10 and 15 years of service. Initially, the association demanded four ACPs (after four, nine, 13 and 20 years), but, in July 2024, agreed to three ACPs at higher grades.The scheme has not been implemented despite this compromise, the association alleges.What’s next?The HCMS Association has warned of an indefinite strike if its demands are ignored. To maintain services, the government has deployed junior and senior residents from medical colleges, as well as Ayush doctors and those from the National Health Mission.Story continues below this adBut health services are expected to be affected if the strike continues. Dr. Anil Yadav said that around 2,300 doctors out of 2,700 medical officers participated in the strike on December 8 and 9. Experts caution that diverting medical college doctors to hospitals will ultimately disrupt services at the colleges too, creating a wider impact across the healthcare system.